Creating space to talk about patients’ personal goals: experiences from primary care stakeholders

Abstract

Background To address the many challenges health systems and communities face, primary care is constantly searching for new strategies to improve quality of care. One of the strategies is to focus on patients’ personal goals to direct the care process. To adopt an explicit focus on patients’ personal goals, actions at different levels are required. As a first step in this process, this study aims to explore the experiences of primary care stakeholders (i.e., scholars, primary care providers, and policy makers) and develop a comprehensive understanding on the idea ‘putting patients’ goals first’. This will help to formulate suggestions about what these actions should include. Method In this study, 41 primary care stakeholders participating in six focus groups between January 2020 and September 2020, were recruited via maximal variation purposive sampling. Data collection was done through an open-ended semi-structured interview guide. Focus groups were audio-recorded, transcribed verbatim, and analyzed following a phenomenological-hermeneutical philosophy of Lindseth and Norberg. Results All participants expressed a strong fundamental belief for putting patients’ personal goals first. The primary care providers shared that they created space for patients’ personal goals by letting them talk about their values and stories. They reported to integrate their medical expertise with patients’ personal goals in order to develop a balanced relationship. In this context, they also talked about the importance of taking into account the perspectives of patients’ significant others. Primary care providers also talked about how they used patients’ personal goals as a guide in interprofessional collaboration. Scholars denoted that (future) care providers need more training to acquire competencies to discuss patients’ personal goals. The providers and policy makers talked about organizational limitations in terms of time restrictions and the lack of registration systems to support a workflow oriented towards patients’ personal goals. Conclusions This study can be used to support the coherence of the development of different actions and strategies to get primary care stakeholders fully on board to support the adoption of patients’ personal goals in care delivery at different levels. However, models of practice and policy plans are needed to work towards a person-centered integrated system.

Primary healthcare competencies needed in the management of person-centred integrated care for chronic illness and multimorbidity: Results of a scoping review

“…Educational training of both undergraduate as well as graduated healthcare professionals is needed to better prepare healthcare professionals to meet the needs of ageing patients with multiple chronic conditions in a way that is person-centred, effective and sustainable [ 49 ]. Patients’ personal goals can be used as a guide in interprgessionl collaboration as it might have the porential to integrat different care plans with each other [ 50 ]. However, there is still a need for professionals to acquire competencies to discuss patients’ personal goals through training [ 50 ].…”

“…Patients’ personal goals can be used as a guide in interprgessionl collaboration as it might have the porential to integrat different care plans with each other [ 50 ]. However, there is still a need for professionals to acquire competencies to discuss patients’ personal goals through training [ 50 ]. Interprofessional education has an important role to play in professionals developing the competencies required to collaborate successfully [ 47 ].…”